[18F] Experiencing severe menstrual cramps and heavy bleeding

Patient Description

An 18-year-old female presents with severe menstrual cramps that are unresponsive to pain medication, causing her to double over in pain. The pain is described as violent stabbing across the lower to mid abdomen. She has been experiencing these symptoms since the onset of her menstruation approximately five years ago. Additionally, the patient reports very heavy menstrual bleeding, requiring frequent changes of ultra-size tampons every two hours, and the presence of large blood clots. She also experiences pain while trying to use the bathroom and has had soft but slightly hard stools two days ago. The patient occasionally experiences chills but no frequent fever. There is no mention of dizziness, lightheadedness, or fainting. No other medical conditions or medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, potential diagnoses include:

  • Dysmenorrhea: This is the medical term for painful periods. It's a common condition that can cause severe cramps and heavy menstrual bleeding. However, the severity of your symptoms suggests that there may be an underlying condition causing your dysmenorrhea.

    • Treatment typically involves over-the-counter pain relievers, hormonal birth control, and lifestyle changes such as exercise and a healthy diet.
  • Endometriosis: This is a condition where tissue similar to the lining of the uterus is found outside the uterus. It can cause severe menstrual cramps, heavy periods, and pain with bowel movements.

    • Treatment can involve hormonal therapies, pain management, and in some cases, surgery.
  • Uterine fibroids: These are noncancerous growths in the uterus that can cause heavy menstrual bleeding and severe cramps.

    • Treatment can range from medication to manage symptoms to surgical removal of the fibroids.

What you can do

Given the severity of your symptoms, it's important to seek medical attention. A healthcare provider can provide a formal diagnosis and discuss treatment options with you. In the meantime, you can:

  1. Use a heating pad on your lower abdomen to help alleviate cramps.
  2. Try over-the-counter pain relievers such as ibuprofen or naproxen.
  3. Practice relaxation techniques such as deep breathing or yoga to help manage pain.

What you should look out for

Seek immediate medical attention if:

  • Your pain becomes so severe that you can't perform your usual activities.
  • You develop a high fever.
  • You experience sudden, sharp abdominal pain.
  • You have signs of shock, such as cold and sweaty skin, rapid breathing, dizziness or lightheadedness.

Please remember that while I strive to provide accurate information, I'm not a doctor. Always seek advice from a healthcare provider for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common causes of severe menstrual cramps and heavy bleeding?

Severe menstrual cramps and heavy bleeding can be caused by conditions such as dysmenorrhea, endometriosis, and uterine fibroids. These conditions can lead to intense pain and increased menstrual flow, often requiring medical evaluation and treatment.


How is endometriosis diagnosed and treated?

Endometriosis is diagnosed through a combination of medical history, pelvic exams, imaging tests like ultrasounds, and sometimes laparoscopy, which is a surgical procedure. Treatment options include hormonal therapies, pain management, and in some cases, surgery to remove endometrial tissue.


What are uterine fibroids and how do they affect menstrual cycles?

Uterine fibroids are noncancerous growths in the uterus that can cause symptoms like heavy menstrual bleeding, severe cramps, and pelvic pain. They can be managed with medications to control symptoms or surgically removed if they cause significant issues.


When should someone with severe menstrual symptoms seek immediate medical attention?

Immediate medical attention should be sought if menstrual pain becomes so severe that it interferes with daily activities, if there is a high fever, sudden sharp abdominal pain, or signs of shock such as cold and sweaty skin, rapid breathing, dizziness, or lightheadedness.

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